If you are noticing your child is having trouble falling asleep and staying asleep, the routine you have, or don’t have for that matter, may be playing a key role.  People inherently are creatures of habit and seek out repetition and routine. This is in part due to our nature and to our internal body clock called the circadian rhythm which thrives on routine and predictability. The circadian rhythm begins to develop in infants between three and four months, and is the main drive of sleep for all of us. If you are noticing your child is having trouble falling asleep and staying asleep, the routine you have, or don’t have for that matter, may be playing a key role. Here are some ways to make your sleep routines conducive to healthy sleep. Mind your P’s and cues: The cues you offer your child from a very early age matter when it comes to sleep. Incorporate consistent cues in your routine that indicate to your child “we’re getting ready for sleep”. Soothing activities like dimming the lights in your house at least 30 minutes prior to bedtime, a diaper change, getting into pajamas, nursing, bottle or cup of milk, stories or gentle songs, are all great ways to let your child know what’s coming next. Keep your routine relatively short. From start to finish an appropriate bedtime routine should range between fifteen and thirty minutes. Offer consistency by doing the same things each night in the same order and begin your routine within the same thirty minute window every evening. For example if your child’s bedtime is 7:30, you will want to finish your bedtime routine and put your child to bed somewhere between 7:15 and 7:45. Timing is everything: Be certain your child’s body is ready for sleep when you are asking her to sleep. Note the time your child actually falls asleep at night and wakes up each morning. It is important to be familiar with your child’s individual rhythm. Laying her down for sleep well before she is actually able to fall asleep can create bedtime turmoil for infants and toddlers. If your child is falling asleep within 5-20 minutes of laying down, then you probably have your timing right. If your child is asleep before they are placed in their crib or bed or they are still awake after twenty minutes, those are signs you need to tweak the time your child is going to bed. The right routine at the right time: A six month old, an eighteen month old, and a three year old all need a bedtime routine. However, age and stage of development should dictate what activities you implement and when. A young baby will rely on gentle activities such as a bath, massage, breast feeding or bottle, swaddle or sleep sack and perhaps a song or book. While a feeding is typically a necessary element in a baby’s routine, it works well if it takes place somewhere in the middle of the routine instead of happening last. The bedtime feeding should indeed be a feeding and not a parent led association that causes your child to fall asleep. Young toddlers are gaining independence and will begin to seek more control over what happens during the time leading up to bed. For example, hold your toddler up to turn their light switch off or make a bed for one of their stuffed animals and ask them to tuck-in their “baby” before you tuck them in. Toddlers and young children enjoy being active participants in their bedtime routines and can enjoy a little fun and whimsy, as long as it’s nothing that is over stimulating. Preschool and school age children will be ready for even more responsibility at bedtime, but will also be likely to test limits; consistency here is key! Let your child choose which books will be read, but set a limit of two to three books and stay consistent. It is typical for older children to use delay tactics at bedtime with extra requests for hugs, kisses, drinks or bathroom trips. Giving your child “one more tickets” can be a great tool for older children. The concept is that you give your child a tangible ticket at bedtime and they have the opportunity to utilize the tickets for one request, but when the tickets are gone, no more requests will be fulfilled. Again, consistency is the key to this system working. Also remember, your child will likely use each ticket every night, so limit it to one or two. Routine rut: The right routine will be different for each family and a good bedtime routine should be calming and enjoyable for both you and your child. If you start to notice what you’ve been doing isn’t working well, then it’s time to make a change. Begin slowly by either adding or eliminating one element and expect it to take 3-4 nights of being consistent before your child learns the new routine. For example, if your child wants to read the exact same books each night and you’re bored to tears, let them choose one and you choose one. Carefully watch your child at bedtime. If your child appears over stimulated, bored, frustrated or distracted, it may be time to figure out what’s not working and switch things up. Consistency: A bedtime routine that is appropriate for your family and is offered consistently will play a huge role in the success you have with getting your child to sleep each night. It is stress reducing for the entire family if everyone knows what the expectations are at bedtime. If you have a good routine in place and need to veer from it due to travel or illness, for example, your child will be able to quickly revert back with consistency. Be sure you are being consistent with the elements of the routine that work and not consistently doing things in the evening that hinder your bedtime success! If you are not sure where to begin with creating an appropriate routine or are experiencing other sleep challenges, we can offer individualized support with a sleep consultation.   When you are expecting it becomes commonplace for experienced parents to offer unsolicited advice on how you should prepare for “those sleepless nights” and to “rest up” while you still have the opportunity. The natural reaction, and frankly, your only line of defense, is to laugh these comments off as you think to yourself, “come on, it can’t be that bad’. That is of course until your little one arrives and you get to experience firsthand what it really feels like to be awakened every 2-3 hours (or more) across a 24 hour day while simultaneously juggling the ever demanding responsibilities of life with a baby.
Oftentimes, new mothers (and fathers) are more sleep deprived than they realize; and that sleep loss can take a serious mental and physical toll. For many mothers, the effects of sleep loss begins prior to baby’s arrival with restless uncomfortable nights and only increases after the birth during a stay at the hospital. It is not until you arrive home with your new baby, who doesn’t follow the day and night pattern of wakefulness and sleep, that sleep deprivation and the impacts it has on your overall wellness sets in. And it is like nothing you have ever experienced or could have prepared for. Sleep is as necessary a biological function as breathing air and eating a healthy diet, yet for some reason, its importance seems to fall lower on the totem pole. Dr. Christina Hibbert, an expert on women’s health, says “Sleep is the body’s way of restoring health and well-being. Sleep loss is associated with poor attention and decision-making, poor performance on routine tasks, more mistakes, diabetes, obesity, and a host of emotional symptoms like depression, anxiety, mood swings, irritability, anger, frustration, and poor coping skills. At its extreme, sleep deprivation can actually induce psychotic symptoms!” At the very least many parents have a story about the time they put the milk away in the cabinet or went to work wearing two different shoes, but sleep loss can be very serious, even triggering postpartum depression. So what is a parent to do? Strategies to Help you Achieve Sleep During the Postpartum Period
Resources http://healthysleep.med.harvard.edu/need-sleep/what-can-you-do/good-sleep-habits http://www.drchristinahibbert.com/  If you live in the Northeast like us, it is hard to think about spring with so much snow still on the ground. However, March 8th is the day we "spring ahead" and begin daylight savings time. The one hour time change is nothing more than a shorter than normal day for most of us. For parents of babies and young children however, it can mark the beginning of challenges around bedtime and established wake times, that remain long after we "Spring Ahead".
If your child has a consistent bed and wake time and is between the age of five months and 5 years, it is important to adjust your child's biological clock slowly to the time change. If nothing is done in advance, the clock time will indicate it is bedtime, but your child's body will not biologically be ready to sleep for another hour. Putting a child to bed an hour before they typically go to sleep can cause a whole host of problems. For example, a toddler may begin popping out of bed when beforehand they would have fallen asleep within minutes. A young baby may become frustrated with the extended period of time in the crib and suddenly require your presence. These are just two scenarios where long lasting bedtime challenges can begin to be formed. Think Small Changes The body responds best to time changes in small, 15-30 minute increments. If nothing is done beforehand to adjust your child's body, she will feel the need to sleep an hour later than her normal bedtime. To shift your child's body clock slowly over the course of a week, adjust her bedtime 15-20 minutes earlier each day leading up to daylight savings time. When March 8tharrives, she will be going to bed at her typical bedtime by the clock, which biologically, is an hour earlier. For example, if your child's bedtime is 7:30, the shift schedule would look like this: Bedtime: 7:30
It is important to remember that your child's wake-up time and nap time should also be adjusted each day in accordance with the shift at night. If your child's wake time is typically 7:30, you would begin by waking him at 7:15 on day one and continue to shift the time back following a similar schedule as listed above until the established wake time is reached. Morning wake time sets the tone for naps, therefore naps are simultaneously shifting earlier as you shift the schedule earlier. If you have a child whose wake time is too early, you can use daylight savings as an opportunity to remedy the situation by letting him sleep an hour later by the new clock time. It must be pointed out that this will only apply to a child whose too early wake-ups have been leading to shorter than recommended sleep at night. The majority of children between the ages of 5 months and 5 years, require between 10.5 and 12 hours of sleep a night. It is not realistic to expect a child will biologically begin to sleep longer hours at night if they are already within their healthy norm. If this is the case for your family, then we would recommend that you not adjust bedtime as explained above. Alternatively, put your child to bed at their regular biological bedtime, which will be an hour later according to the new clock time. As mentioned above, adjusting the nap schedule in accordance with wake time is important so that your child is not napping later in the day. If a nap is too close to bedtime it can sabotage the ability to fall asleep at night due to the lack of "sleep pressure". This may mean waking your child early from their last nap to protect the earlier bedtime. Typically a toddler requires 5 hours of wake time before going to bed in the evening and a baby older than 6 months needs approximately 2.5-3 hours. Use Darkness and Light to Reinforce Desired Schedule The circadian rhythm, a main driving force for sleep, is very sensitive to light and dark cues. To prepare your child's body for an earlier bedtime, dim the lights in your house and avoid exposing your child to natural light in the evening. Conversely, use light exposure in the morning to help wake-up times remain consistent. The light we are exposed to in the morning "locks in" our circadian rhythm. If you are trying to solve the problem of a too early wake time, do not expose your child to morning light. Be Realistic Remember, your baby or young child is not able to tell time and relies on those cues her body sends her to know when she's supposed to go to sleep and when she is supposed to wake-up. Whether you implement a change before daylight savings time or after the clocks are turned, it is realistic to expect that it should take at least 3-4 days before your child will be fully adjusted to the time change. Do you need individualized support? We can help with a sleep consultation for your family. |
Joanna Silverman
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